This blog is my place to vent and share resources with other parents of children of trauma. I try to be open and honest about my feelings in order to help others know they are not alone. Therapeutic parenting of adopted teenagers with RAD and other severe mental illnesses and issues (plus "neurotypical" teens) , is not easy, and there are time when I say what I feel... at the moment. We're all human!

Thursday, September 28, 2017

Hoarding is considered an offshoot of Obsessive Compulsive Disorder (OCD), but recently this categorization is being reevaluated. It’s estimated that about one in four people with OCD also are compulsive hoarders.

Without exception, hoarding is always accompanied by varying levels of anxiety and sometime develops alongside other mental illnesses such as dementia and schizophrenia.

Recent neuroimaging reveals peculiar commonalities among hoarders including severe emotional attachment to inanimate objects and extreme anxiety when making decisions.

Hoarding both relieves anxiety and produces it. The more hoarders accumulate, the more insulated they feel from the world and its dangers. Of course, the more they accumulate, the more isolated they become from the world, including family and friends. Even the thought of discarding or cleaning out hoarded items produces extreme feelings of panic and discomfort.

Age: While severe hoarding is most common in middle-aged adults around the age of 50, their hoarding tendencies began around ages 11 to 15. During these early teenage years, they typically saved broken toys, outdated school papers, and pencil nubs.

Genetics: Although hoarding is not an entirely genetic disorder, there is some genetic predisposition involved in the disorder.

Trauma: Many hoarders experienced a stressful or traumatic event that propels them to hoard has a coping mechanism.

Social Isolation: Hoarders are often socially withdrawn and isolated, causing them to hoard as a way to find comfort.

Why Children with Attachment Issues Are More Likely to Have Issues with Clutter, Hoarding, Chores, and Cleaning Their RoomChaos feels normalA child who grew up in chaos might act in ways to trigger that chaos, because that is the "norm" for their neurological system. Even a child who came straight from the hospital to your home, still might have been "pickled" in stress hormones in the womb. To them, chaos feels "normal," and they will act in ways to make their life feel normal and Safe (this is a "perceived safety" and has nothing to do with their current situation - where of course they are safe. Why Doesn't My Child Feel Safe?)How we handled it:Children NEED Structure and Caring Support to feel safe and start to heal. This feeling of safety is not about physical safety and rarely based in reality – it is a perceived feeling of safety. It feels life or death to them! To help them feel safe, we increased the level of structure we provided.By helping them get and stay regulated, we saw fewer meltdowns and other dysregulated behaviors (like hoarding and being unable to keep their room clean). The more structure and regulation we provided, the more it felt normal to them. Chaos finally started losing its appeal.

Executive Functioning - ex. Attention Deficit Disorder (ADD/ADHD), PTSD, and damage to the frontal lobeIt's common for kids with attachment disorders to have issues with executive functioning. Executive functions are a set of processes that all have to do with managing oneself and one's resources in order to achieve a goal.

Working Memory - Being able to hold something in mind and then use it (like a list of tasks/ chores or how you told them to do something).

Cognitive Flexibility - the ability to think about things in more than one way to solve a problem.

Inhibitory Control (self-control) - being able to regulate emotions, ignore distractions, and keep from acting impulsively.

Sound familiar? All of course are required to be able to do chores and clean their room! See the post Chores, Responsibilities, and Other Things my Children Can't Handle.How we handled it: This depended on what was causing the issues. For the ADD/ADHD - we mostly chose the medication route, but this post has some additional ideas. For the PTSD and other trauma issues, it took time and therapy. This post has some additional ideas. Unfortunately, for the brain injuries, like damage to the frontal lobe, we were able to help the children learn some "work around" techniques. This post has some additional ideas.Too Many Steps An overwhelmed child will often freeze or even regress to more child-like behaviors. Kitty was not able to do things independently, like clean her room. Especially in the early days of her time with us. How we handled it.First, I cut back on the chore expectations. I changed what I thought she "should" be able to handle, to more (emotional) age-appropriate tasks. I would break down tasks into small steps and give them to her one at a time. Instead of saying, "Clean your room," which was overwhelming and just didn't happen. I would say, "Empty your trashcan." and when that was done, then I would say, "Put your dirty clothes in your laundry basket." When that was done, I would say, "Put your laundry basket next to the washing machine." Most of the time, I would have to do these things with her (not for her, but be present in the room, often helping clean near her). Chores, Responsibilities, and Other Things My Kids Can't Handle.

Eventually, she got to where she could do a few tasks at a time, but the chaos in her head will always be reflected in the chaos of her room. I still help her keep it regulated. Therapeutically Parenting the Adult Child

Why Do They Do That?Sexual AbuseA sexually abused child may try to make him/herself "unattractive" by being "dirty" or smelly. This can include his or her room.How we handled it:Chapter 6: AbuseA related post about why my child's room (and person) reeked and how we handled it - The RAD Stink.Addictive PersonalityThe Addictive BrainFinally an article that puts in to better words why my son has an "addictive brain." We've seen evidence of it for years, and knew it wasn't the drugs themselves, because the addiction shifted often and he could stop seemingly cold turkey (drugs, alcohol, tobacco, but also sugar/ junk food, sex, stealing, adrenaline, chaos...)."Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It's how we get our satisfaction. If we can't connect with each other, we will connect with anything we can find -- the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about 'addiction' altogether, and instead call it 'bonding.' A heroin addict has bonded with heroin because she couldn't bond as fully with anything else."So my son remains "addicted." In part because his attachment issues - the (in)ability to make human connections - haven't really healed, but also because his Chronic Post Traumatic Stress Disorder means he is stuck living in a "war zone" 24/7. He carries his old "cage" with him wherever he goes.How we handled it: The Addictive Brain

Food HoardingThis post has more information about why kids hoard food, which has some commonalities/ similarities to why they hoard trash and clutter.How we handled it: Food/ Hoarding/ DietHypervigilance/ Living in a WarzoneKids of trauma are often easily triggered, extremely sensitive to emotions, unable to regulate their emotions... causing them to react as if they are in a warzone. You can't learn and attach if you don't feel safe and you're living in a war zone! Hypervigilance (obsessively monitoring their environment) is super common among kids with PTSD. It relaxes when they start to feel safe, but probably doesn’t ever really go away.How we handled it: Why Doesn't My Child Feel Safe?Poop and Other Bodily Fluids It's part of them. Some children develop an irrational fear of the potty or "losing" part of their body (poop). I have seen a child "hold it" all day to avoid having to use the restroom at daycare, waiting instead until she was put in a diaper at night - causing serious intestinal issues. I've heard of kids hoarding/ hiding jars of pee, dirty pull-ups, used kotex... I can only assume at least part of this is related to whatever causes them to hoard. How we handled it: Potty Issues - What's That Smell?

Low Tolerance/ Overwhelm

Our kids tend to have a low tolerance for stress and are easily overwhelmed. How we handled it: SimplifyIt is sometimes necessary to simplify a child’s life a LOT to lessen the feeling of “overwhelm.” This can be like childproofing – avoiding and removing things and events that can be triggers.Make Their World SmallerThis can be making their world smaller and lowering expectations. Level Chart post.Strip The RoomFollowing a therapist's advice, we stripped the child’s room to only a bed, one or two stuffed animals, a book, and not much else. In times of extreme stress, we moved our child's dresser to our room. The child had to bring dirty clothes to “check out” clean ones. This helped with hygiene issues, and lessened the amount of overwhelm. It made cleaning the room easier for the child to do him/herself (if they were able to do it alone at all). Room and Belongings Searches Bear frequently stole things and hoarded food and other items. Usually when searching his room, I gave it a good cleaning and removed all contraband and health hazards. While I usually did this randomly when he wasn't at home, Bear was aware that we did this for his safety, and rarely protested - even when I found contraband and gave him consequences.Age Appropriate Expectations - Expectations are reduced to the child's emotional age. Kitty may be 16, but when dysregulated, emotionally she'd drop to about 6yo. Her daily chores became super basic.We had a long discussion with Kitty about being emotionally 6 (still ticks her off to hear that), and that it wasn't fair to expect her to be able to handle certain things, and we felt it was cruel to dangle higher level privileges she couldn't actually achieve over her head. So therefore, I was going to stop "punishing" her for not being able to do things she wasn't ready for yet. Age Appropriate ExpectationsChores-We gave Kitty fewer chores and they are very simple and concrete. They were chores that would normally be given to a younger child (her emotional age). She did the same chores every day instead of rotating like the other kids. ChoresPut It in WritingLists cut down on the arguing. It always surprises me how much less the pushback is when I say, "Is your list done?" instead of, "Do {this} now." I think it's because there is less implied "criticism" from a list. Criticism is probably one of Kitty's biggest triggers, even if there was no criticism happening. It's not a reality based thing, it just feels like it to her.Changing Your ExpectationsChanging my expectations has helped ME immensely (Finding the Joy). I'm less frustrated by her inability to do things that would be "normal" for a teen. I do have to constantly remind myself "She's only 6! She's only 6! She's only 6!"DeclutterAt home, I did things like declutter and clean the child's room myself (Decluttering), because even with me helping them clean, it was overwhelming. So I did it when they weren't there, although I let them know ahead of time. I left nothing but a bed, a book/ quiet toy, and a stuffed animal, at one point I even had my daughter's dresser in my room, and she "checked out" her clothing by bringing me the dirty ones, THIS WAS NOT A PUNISHMENT. I tried to find ways to help them understand that. I pointed out that now cleaning their room would be a lot easier! (Explaining Age-Appropriate Parenting to Your Child)DE-CLUTTERING IDEAS:Decluttering PostKid school projectsFor all the cute school stuff the kids brought home, I'd put it in a folder marked with their name and age/school grade. A couple of years later, surrounded by the detritus of 2-4 kids' massive amounts of awards, report cards, stories, art projects I am able to go through it again and be fairly vicious. You can also take a picture of the item and trash the original.Moving TimeEvery time we move stuff around (like when I had to give up my sewing room to Bob for a bedroom), I try to go through it again with an eye to "what have I used recently... or never"?Santa is ComingTwice annually, I try to have the kids go through the house and de-clutter their own stuff. It works especially well to do it over the Thanksgiving holiday. I think I've blogged about this before. Basically I tell the children that Christmas is coming and they have too much stuff. Lots of kids would love the stuff that they no longer play with and the more they give away the more room they'll have for new toys from Santa!Numbers GameWhen going through items they had many of, I told them they could keep "X" number of items. I tried to make it sound like I hadn't just pulled the number out of the air. Sometimes it was based on their age, how many they needed (7 days in a week so 10 shirts), or how much room the toy took up (Ex. Ponito got to keep more match box cars than his age that year, but Bob could only have 10 stuffed animals). I didn't tell them my reasoning, just said, "You can keep 10 stuffed animals." This way the control issues were kept to a minimum and they didn't argue with me about what should be kept (it wasn't my decision it was theirs!). Helped them learn to prioritize what they like and wanted.Fashion ShowI don't know how the clothes manage to accumulate like bunnies (except for socks of course, which disappear singly). Rather than just having them try on clothes, we make it a little more fun with a "fashion show." Once we have clothes pared down to just what fits, then they have to pair it down to just what's needed (the rest can go in the Clothes Closet or Good Will bag), usually one for every day of the week, plus a couple of extras. They get to choose which clothes they want to keep.Clothes ClosetClothes are back to being a huge issue for me because the girls and I wear similar sizes and all of us fluctuate in weight so it's harder for me to get rid of the clothes (I want to hang on to them just in case). I tend toward classics so it's not as easy as throwing away all the acid wash jeans with zippers and the ripped up sweatshirts (am I showing my age)?Garage Sale PricesI paid the kids $1 a bag (large kitchen trash bags) for all the toys they got rid of - the theory was I would sell them at some future date in a garage sale and this way they got their share of the money now instead of waiting and hoping it would sell. We got rid of a lot of those McD*nald type toys that clutter up everyone's toy boxes! I also paid them $1 for full bags of trash (to try to avoid the kids putting trash in the sale bags to fill them up faster).Sort ImmediatelyLaundry is my nemesis. I try to put the laundry basket near the drawers or closet where the majority of them go and put them away directly into the appropriate drawer, but I have to admit, we have a couch in our bedroom that is draped with sorted piles of clean clothes (my husband's shirt stack, my shirt stack, his undies, my undies, matched socks, folded towels...). Not sure why I have trouble doing that extra step of actually putting them away.Paperwork is my other big clutter issue. Hubby keeps every bill we ever had - mostly not opened because he pays online - and that's a LOT! I have IEPs, psych evals, applications, reports... for both kids. I've gotten a little more organized about that, because otherwise the piles will eat me (I love my 3" 3-ring binders). Now that I'm in two NAMI classes, trying to study for my social work license, and keep up on my reading, that adds up too. I try not to even go to the mailbox unless I'm ready to sort right then. Hubby's, Old Company, Mine, and Trash (recycling). Coupons and stuff go in my car - which I usually end up throwing away as they expire.InspirationI read books about de-cluttering, watch lots of trash TV including things like Clean House and other decorating shows for inspiration. I signed up for Fly Lady at one point - which was really helpful. Of course the kids are old enough now to do lots of stuff for themselves (laundry, dishes, etc.) as evidenced by our chore chart.More posts on techniques for stripping/ decluttering the room:Adult Boarder vs "Family Girl"Therapeutically Parenting the Adult Child

How To Strip a Room:

When Bear finally officially moved out. His room was way worse than this. And it wasn't the first time I had to do this. {Post:Ewww!!!}

Here's what I did:

1. Wore gloves. My daughter, Bob, was helping me one time and picked up a used condom with her bare hands. She never helped me again, and I started wearing gloves!

2. Gathered up Containers and Supplies -

Gloves!

Box of white kitchen trash bags

Black sharpie to label bags.

Tied a trash bag to my belt loop.

Labeled a bag for Donate (I used white kitchen trash bags for these so I could write "Donate" on the bag and it wouldn't get mixed with trash).

Box for things that belonged elsewhere in the house.

Bag for dishes and cups.

Several laundry baskets.

One Rubbermaid Tub for things he might want to keep (high school diploma, pictures of his birth family, school yearbook, winter coat...)

Cleaning supplies - for later, I emptied the room first.

3. Started at the Doorway and worked my way in to the room. Once the floor was clean enough to stand in the room, I'd pick something to start with (a dresser, a book shelf, the bed...). Once it was stripped, then I'd move to the next area.

4. Threw it in the Hall. When a bag, box, or basket got full, I'd throw them out into the hall.

5. Take it Where It's Supposed to Go. Whenever the hall got full, I'd take out the trash, line up the Donate bags by the front door to be loaded in to my car, drag the laundry baskets to the laundry room and dump them on the floor so I could take the baskets back upstairs (and start or switch over a load). Dump the dishes in the sink. Then I'd start again until the next time the hallway got too full.

On one of these cleanings, I pulled out 20 loads of laundry (clothes, towels, bedding, About 9 bags of trash. 1-2 bags of donate (most stuff was too trashed to donate). 1 large Rubbermaid tub of things he might want to keep. Only one bag of dishes! And a relatively small pile of things that weren't his (it hadn't been that long since I last searched his room for contraband).

6. Sort. When the laundry was clean, I had 3 kitchen trash bags of clothes labeled by size (his weight fluctuated - Med, Large, XL). I dispersed the remaining laundry and the box of stuff that wasn't supposed to be in his room (kitchen towels, bathroom towels that weren't his, stuff he'd stolen...) where they was supposed to go. Stuff stolen from non-family members went to the school so they could figure out who it belonged to.

7. Clean! Start at the top (ceiling fan) and work your way down. I used a lot of 409 type cleaners.

Those big white patches on the wall are where he punched his fist through the wall.

8. Repair. Patch holes in the walls (he often punched his fist through the walls), replace furniture and repair things like the ceiling fan and window curtains, repaint, and throw away carpet (as needed).

We had to throw away the carpet, because we discovered he was spitting in the house. The walls also had to be sanded down and repainted for the same reason.

About Me

I'm the admin for a large, international support group on Facebook called Parenting Attachment-Challenged Children. I have a Masters degree in Social Work, a bachelors in Psychology with a focus on child abuse and neglect, and over 30 years of experience working with children and families, in particular those with special needs.
Hubby and I adopted special needs teenage siblings in 2008 - a son, (Bear, now 26) and daughter, (Kitty, now 24). Both are diagnosed with RAD, Bipolar Disorder, ADHD, Borderline Personality Disorder, C-PTSD, brain injuries... and many other diagnoses. We also have two younger bio children, a daughter, (Bob - see the post "What about Bob" if you're dying to know how she got her nickname -age 23) and a son, (Ponito, 21).
I love to help, and I hope my blog provides resources and support for parents struggling with children with attachment and trauma challenges.

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Books, Methods, and Resources Review

BOOKS, METHODS, AND RESOURCES REVIEW

This is a "living anecdotal document" reviewing books and methods specific to the many issues in parenting children of trauma that I have come across over the years. I share it with you, because I wish I'd been able to find resources when we started this process. Please let me know if you have any suggestions, comments, or additions!**********************************INTRODUCTION - Books, Methods, and Resources Review

Katharine Leslie is one of my favorite attachment gurus (she's also a parent of RAD kids!). She gives great practical advice, especially for those working with older children. The majority of these posts are based on two ACT seminars I attended where she was the main speaker. I strongly recommend you read her books!******************************************